Individual
MISS SAVANNAH LEE PODLISKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
700 CAMPBELL ST, BAKER CITY, OR 97814-2212
(541) 523-0607
(541) 523-0589
Mailing address
700 CAMPBELL ST, BAKER CITY, OR 97814-2212
(541) 523-0607
(541) 523-0589
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CPT-0006409
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CPT-0006409
STATE PHARMACIST LICENSE
OR
Enumeration date
03/12/2012
Last updated
03/12/2012
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